Optional Practical Training (OPT) STEM Request

To be completed by STEM degree holder who is currently on a 12-month period of OPT.

Last (Family) Name

First (Given) Name

SEVIS ID#

Major

Degree

Date of Degree Completion

Current OPT End Date(recommendation will be for 24 months from this date)

Email

Phone Number

Residential Address
(This address will be reported to SEVIS as the address where you are currently living.
Note: Your immigration documents will be mailed to this address.)

City

State

Zip

Employer Information

Employer's Name

Employer's Address

Employer's City

Employer's State

Employer's Zip

Employer's Phone

Employer's E-Verify Number

Position/Job Title

Explain how this position is related to your field of study.

Supervisor's Name

Supervisor Telephone Number

Additional

How would you like to receive your new STEM Extension I-20?

I will pay for a courier label (FedEx, DHL, etc.). Click here for instructions.Please note that the ISSS office will not ship your I-20 until you have completed a shipping request.

I will pick up my I-20 from the ISSS office.*

*If you are unable to personally collect your Form I-20 from the ISSS office, you must select the option above to pay for a courier label. ISSS will not authorize any individual other than yourself to collect your Form I-20.

Please email the following documents to isss@fit.edu with the subject line "OPT STEM Extension Application Documents". Your request cannot be processed until all documents and this form are submitted. Once all documents are submitted, please allow 3-5 business days for the ISSS office to process your request.

Copy of current OPT/EAD Card

Copy of completed Form I-765

Copy of completed Form I-983 (page 5 does not need to be completed at this time)

Statement of Understanding

I have not previously received more than one (17 or 24-month) OPT extension after earning a STEM degree.

I have maintained valid F-1 status since I began my study at Florida Institute of Technology.

I understand that I must report to ISSS (using the OPT Reporting Form) any change to the following within 10 days:

legal name

residential or mailing address

employer name

employer address

loss of employment

I understand that I am required to make a validation report to ISSS every six months starting from the date the extension begins and ending when my F-1 status ends; I change educational levels within Florida Tech; I wish to transfer to another school; or the 24-month OPT extension ends, whichever is first. I understand that the validation is a confirmation that my name and address, employer name and address and/or loss of employment are current and accurate. This six-month validation report is due to the ISSS within 10 business days of each reporting date. Such validation reporting should be made using the OPT Reporting Form.

I understand that if there are any material changes to or deviations from the training opportunity described on Form I-983, my employer and I must submit a modified I-983 training plan to isss@fit.edu. Examples of material changes include, but are not limited to:

A significant decrease in my work hours per week;

Any decrease in my hours worked below 20 hours per week (other than due to time off pursuant to employer's leave policy)

Any reduction in my compensation (other than due to a reduction in my work hours);

A change in my employer's EIN number due to a corporate restructuring; and

Any change or deviation from the existing plan that would render my I-983 training plan or my employer's attestations inaccurate

I understand that I am required to submit 12-month and 24-month evaluations using form I-983. The evaluations should be submitted to isss@fit.edu.

I understand that accruing an aggregate of more than 150 days of unemployment during the total of 36-month OPT period will result in a violation of the requirements for remaining in valid F-1 status.